| Major Depressive Disorder
Rexulti vs Zoloft
Side-by-side clinical, coverage, and cost comparison for major depressive disorder.Deep comparison between: Rexulti vs Zoloft with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsZoloft has a higher rate of injection site reactions vs Rexulti based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Zoloft but not Rexulti, including UnitedHealthcare
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Category
Rexulti
Zoloft
At A Glance
Oral
Once daily
Atypical antipsychotic
Oral
Daily
SSRI
Indications
- Major Depressive Disorder
- Schizophrenia
- Agitation in Dementia
- Major Depressive Disorder
- Obsessive-Compulsive Disorder
- Panic Disorder
- Post-Traumatic Stress Disorder
- Phobia, Social
- Premenstrual Dysphoric Disorder
Dosing
Major Depressive Disorder Start 0.5 mg or 1 mg orally once daily; titrate to target 2 mg once daily; maximum 3 mg once daily.
Schizophrenia Adults: start 1 mg once daily, titrate to target 2-4 mg once daily (max 4 mg); pediatric patients 13-17 years: start 0.5 mg once daily, titrate to target 2-4 mg once daily (max 4 mg).
Agitation in Dementia Start 0.5 mg orally once daily; titrate to target 2 mg once daily; maximum 3 mg once daily.
Major Depressive Disorder Starting 50 mg/day orally; max 200 mg/day; titrate by 25-50 mg/day increments once weekly if inadequate response.
Obsessive-Compulsive Disorder Starting 25 mg/day (ages 6-12) or 50 mg/day (ages >=13) orally; max 200 mg/day; titrate by 25-50 mg/day increments once weekly if inadequate response.
Panic Disorder, Post-Traumatic Stress Disorder, Phobia, Social Starting 25 mg/day orally; max 200 mg/day; titrate by 25-50 mg/day increments once weekly if inadequate response.
Premenstrual Dysphoric Disorder Continuous dosing: starting 50 mg/day orally, max 150 mg/day; intermittent (luteal phase only): starting 50 mg/day, max 100 mg/day.
Contraindications
- Known hypersensitivity to brexpiprazole or any excipient (reactions include rash, facial swelling, urticaria, and anaphylaxis)
- Concomitant use or use within 14 days of stopping MAOIs, including linezolid and intravenous methylene blue, due to increased risk of serotonin syndrome
- Concomitant use of pimozide
- Known hypersensitivity to sertraline (e.g., anaphylaxis, angioedema)
- Concomitant use of disulfiram with ZOLOFT oral solution (contains alcohol)
Adverse Reactions
Most common (>=5%) weight increased, akathisia, headache, somnolence, insomnia
Serious neuroleptic malignant syndrome, tardive dyskinesia, metabolic changes, leukopenia, neutropenia, agranulocytosis, orthostatic hypotension, falls, seizures, body temperature dysregulation
Postmarketing neuroleptic malignant syndrome
Most common (>=5%) Nausea, diarrhea/loose stools, tremor, dyspepsia, decreased appetite, hyperhidrosis, ejaculation failure, decreased libido
Serious Suicidal thoughts and behaviors, serotonin syndrome, QTc prolongation and ventricular arrhythmias, increased risk of bleeding, activation of mania/hypomania, seizures, angle-closure glaucoma, hyponatremia, sexual dysfunction
Postmarketing Agranulocytosis, aplastic anemia, Stevens-Johnson Syndrome, toxic epidermal necrolysis, severe liver events including hepatitis and liver failure, QTc-interval prolongation, ventricular tachycardia, extrapyramidal symptoms, pulmonary hypertension, cerebrovascular spasm
Pharmacology
Brexpiprazole is an atypical antipsychotic whose efficacy may be mediated through partial agonist activity at serotonin 5-HT1A and dopamine D2 receptors combined with antagonist activity at serotonin 5-HT2A receptors; the exact mechanism of action in the approved indications is unknown.
Sertraline is a selective serotonin reuptake inhibitor (SSRI) that potentiates serotonergic activity in the central nervous system through inhibition of neuronal reuptake of serotonin (5-HT), with only very weak effects on norepinephrine and dopamine reuptake and no significant affinity for adrenergic, cholinergic, GABA, dopaminergic, or histaminergic receptors; it does not inhibit monoamine oxidase.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Rexulti
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (5/12) · Qty limit (11/12)
Zoloft
- Covered on 5 commercial plans
- PA (1/12) · Step Therapy (0/12) · Qty limit (3/12)
UnitedHealthcare
Rexulti
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (6/8)
Zoloft
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Rexulti
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Zoloft
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableHealthWell: Cancer-Related Behavioral Health
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Zoloft.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.